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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91900669

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of ShirleyGaum Sex Female

Date of Birth December 25, 1922 Place of Birth SydneyCounty of Cape Breton

Name of Father Benjamin Gaum MAIDEN NAME of Mother Fanny Helman

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born Victoria Road, Sydney, Cape Breton Co., NS Present address of Father 144 Prince Street, Sydney, Cape Breton Co., NS

Occupation of Father at Birth of child Merchant Place of birth of Father Russia

Race Name and present address of Physician in attendance at birth

Signature of Applicant Fanny Gaum Address of Applicant 144 Prince Street, Sydney, Cape Breton Co., NS Date 8 August 1945

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of ShirleyGaum

Born at Sydney in the County of Cape Breton

That ShirleyGaum Whose Birth is sought to be registered was

born at Sydney Cape Breton County on December 25, 1922

My knowledge of the fact and date of such Birth is based on the following Circumstances:

That I am the mother of Shirley Gaum and remember the date specifically

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